Individual
MISS LISA MIYAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
475 22ND AVE RM 127, HONOLULU, HI 96816-4400
(808) 305-9812
Mailing address
475 22ND AVE RM 127, HONOLULU, HI 96816-4400
(808) 305-9812
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-118
HI
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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